RESUMO
La endoftalmitis endógena neonatal es una patología poco frecuente que puede causar daño ocular grave. Puede manifestarse en pacientes con comorbilidades, como nacimiento pretérmino, bajo peso al nacer, complicaciones posquirúrgicas perinatales o sepsis.El presente reporte de caso documenta a una paciente pretérmino que fue sometida a múltiples cirugías abdominales. Durante su internación, desarrolló sepsis, meningitis y endoftalmitis endógena neonatal. La frecuencia extremadamente baja de la endoftalmitis endógena a esta edad, la importancia de preservar la salud visual del paciente y el abordaje interdisciplinario son puntos importantes de aprendizaje en este caso.
Neonatal endogenous endophthalmitis is a rare condition that can cause serious eye injuries. It can manifest in patients with comorbidities, such as preterm birth, low birth weight, post-surgical perinatal complications, or sepsis.This case report documents a preterm patient who underwent multiple abdominal surgeries. During her hospitalization, she developed sepsis, meningitis and neonatal endogenous endophthalmitis. The extremely low frequency of endogenous endophthalmitis at this age, the importance of preserving the patient's visual health, and the interdisciplinary approach are important learning points in this case.
Assuntos
Humanos , Feminino , Recém-Nascido , Endoftalmite/diagnóstico por imagem , Complicações Pós-Operatórias , Endoftalmite/terapia , Enterobacter cloacae , SepseRESUMO
Endophthalmitis is a rare cause of ocular infection that can be associated with immunocompromising conditions and, more rarely, with sickle cell disease. In this case report and review of the literature, we present a case of a young male with sickle cell disease who presented with rapidly progressive ocular pain, edema, erythema, and decreased visual acuity. The key radiological findings to suggest endophthalmitis were demonstrated using computed tomography and magnetic resonance imaging.
Assuntos
Anemia Falciforme/complicações , Anemia Falciforme/diagnóstico por imagem , Endoftalmite/complicações , Endoftalmite/diagnóstico por imagem , Adulto , Humanos , Imageamento por Ressonância Magnética , Masculino , Tomografia Computadorizada por Raios XRESUMO
PURPOSE: To evaluate ophthalmic ultrasound findings in the three presentation forms of ocular toxocariasis (peripheral or posterior pole granulomas and chronic endophthalmitis), in patients with confirmed diagnosis of ocular toxocariasis. METHODS: 11 patients (11 eyes) with clinical and confirmed diagnosis of active ocular toxocariasis, presented positive ELISA test, were analyzed, prospectively, in the study. The patients were submitted to an ocular ultrasound examination (10-MHz transducer, contact technique). RESULTS: In the series of 11 patients, mean age was 7.9 years-old (range from 2 to 17 y), 73% male, referring previous contact with dogs (91%), and with the soil (50%), no referral of appetite perversion. In the analyses of compromised eyes (11 eyes), the ophthalmoscopic examination revealed the following distribution of the 3 forms of ocular toxocariasis: 7 cases (63.6%), posterior pole granuloma; 1 (9.1%), chronic endophthalmitis; 2 (18.2%), peripheral granuloma; and 1 (9.1%), posterior pole granuloma associated with chronic endophthalmitis. Visual acuity impairment: no light perception (3 eyes, 27.3%); hand motion (4 eyes, 36.4%); counting fingers at 10 cm (1 eye, 9.1%); 20/200 (1 eye, 9.1%); 20/70 (1 eye, 9.1%); undefined (1 eye, 9.1%). Serology was positive to Toxocara canis (ELISA test) in 100% of the cases. Ophthalmoscopy was difficult or impossible in 64% of the cases due to the media opacity. Ultrasound findings noted were vitreous membranes with retinal attachment (100%); parietal lesions (granulomas) with high (80%) or medium (20%) reflectivity. CONCLUSION: The most consistent ultrasound finding in the eye with toxocariasis was a high-reflectivity retinal mass, located in posterior pole or periphery, which may be calcified, and which has as main characteristic the adherence of vitreous membranes. In addition to clinical history, systemic evaluation and serology, the ultrasound can help in the diagnosis of ocular toxocariasis, especially in media opacities.
Assuntos
Endoftalmite/diagnóstico por imagem , Infecções Oculares Parasitárias/diagnóstico por imagem , Granuloma/diagnóstico por imagem , Toxocaríase/diagnóstico por imagem , Uveíte/diagnóstico por imagem , Adolescente , Animais , Anticorpos Anti-Helmínticos , Criança , Pré-Escolar , Diagnóstico Diferencial , Cães , Endoftalmite/parasitologia , Infecções Oculares Parasitárias/parasitologia , Feminino , Granuloma/parasitologia , Humanos , Larva Migrans , Masculino , Toxocara canis/imunologia , Ultrassonografia , Uveíte/parasitologiaRESUMO
The authors describe a case of endogenous Candida albicans endophthalmitis in one extremely low birth-weight newborn refractory to endovenous amphotericin B treatment that presented resolution with the use of endovenous fluconazole. Clinical aspects of endogenous Candida albicans endophthalmitis are also pointed out by a review of the literature.